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单侧矢状劈开截骨术后髁突吸收与功能结果

Condylar resorption and functional outcome after unilateral sagittal split osteotomy.

作者信息

Wohlwender Irina, Daake Gert, Weingart Dieter, Brandstätter Anita, Kessler Peter, Lethaus Bernd

机构信息

Oral-Maxillofacial Surgery, Katharinenhospital, Stuttgart, Germany.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):315-21. doi: 10.1016/j.tripleo.2010.10.030. Epub 2011 Feb 3.

Abstract

OBJECTIVE

The objective of this study was to evaluate the radiological and functional results of unilateral sagittal split osteotomy (USSO) of the mandible.

STUDY DESIGN

Between January 2001 and December 2008, 26 patients underwent USSO to correct laterognathia (isolated USSO in 3 patients and Le Fort I osteotomies in combination with USSO in 23 patients). Radiographs of 23 patients were evaluated for signs of condylar resorption or loss of ramus height; 16 patients were clinically examined and the movement of both condyles was measured with a nontouch device.

RESULTS

Unilateral condylar resorption was observed in 1 patient and bilateral signs of resorption with loss of ramus height were observed in a further patient. Mouth opening and protrusion were significantly reduced after surgery (6.06 ± 6.91 mm, P = .005/0.63 ± 0.89 mm, P = .020). The selected surgical site, whether left or right, had no influence on laterotrusion or retrusion (P > .05), but patients operated on the right side showed higher values of protrusion on the left side than patients who were operated on the left (mean difference: 3.13 ± 1.24 mm; P = .038).

CONCLUSIONS

USSO appears to be a procedure that can be used in orthognathic surgery, if applied to a certain extent. In this study, there was no evidence of adverse results in terms of condylar resorption or functional outcome when compared with the results of regular bilateral sagittal split osteotomy (BSSO) reported in the literature. To our best knowledge this is the first study in the literature investigating the impact of USSO in orthognathic surgery.

摘要

目的

本研究的目的是评估下颌骨单侧矢状劈开截骨术(USSO)的影像学和功能结果。

研究设计

在2001年1月至2008年12月期间,26例患者接受了USSO以矫正偏颌畸形(3例患者为单纯USSO,23例患者为Le Fort I截骨术联合USSO)。对23例患者的X线片进行评估,以观察髁突吸收或升支高度丧失的迹象;对16例患者进行临床检查,并用非接触式装置测量双侧髁突的运动。

结果

观察到1例患者出现单侧髁突吸收,另1例患者出现双侧吸收迹象并伴有升支高度丧失。术后张口度和前突度显著降低(分别为6.06±6.91mm,P = 0.005/0.63±0.89mm,P = 0.020)。所选手术侧别,无论是左侧还是右侧,对侧方运动或后缩均无影响(P>0.05),但右侧手术的患者左侧前突值高于左侧手术的患者(平均差异:3.13±1.24mm;P = 0.038)。

结论

USSO似乎是一种可在正颌外科手术中应用的术式,但需在一定程度上应用。在本研究中,与文献报道的常规双侧矢状劈开截骨术(BSSO)结果相比,未发现有髁突吸收或功能结果方面的不良结果证据。据我们所知,这是文献中第一项研究USSO在正颌外科手术中影响的研究。

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